Abstract
Background: Chronic obstructive pulmonary disease (COPD) confers several direct and indirect costs.
Objective: To retrospectively assess healthcare utilisation and societal costs associated with COPD.
Methods: Primary care medical records data from Swedish COPD patients were linked with primary and secondary care national registries data, including prescriptions, mortality, hospital care, income and social characteristics. Direct costs were categorized as COPD- or not COPD-related. Drug costs, outpatient/inpatient costs, and primary care visits were also calculated. Indirect costs (i.e. loss of income) were calculated by comparing incomes of COPD patients with matched reference patients.
Results: 17,545 COPD patients and 84,514 reference patients were analyzed. The economic burden of COPD varied by age group. The main driver of direct costs for all age-groups was non-COPD-related hospital nights. Respiratory drug costs were similar across age-groups; however, costs of COPD-related and non-COPD-related hospital nights increased with age. Direct COPD-related costs increased with disease severity: €7,320 for mild, €8,280 for moderate, €9,230 for severe and €11,810 for very severe disease. For working-age patients, indirect costs was the largest contributor to total economic burden. The mean total cost per year was €17,518; €10,750 as direct and €6,768 as indirect costs. COPD patients' average income was less than half that of the reference patients (e.g. €11,500 vs. €29,000 in 2012).
Conclusion: Non-COPD related hospital nights are the largest direct cost, increasing with age. Direct COPD-related costs increase with disease severity. Indirect costs are the largest economic burden for working-age COPD patients.
- Copyright ©the authors 2016